Vaccine Production is Only the Beginning

In 10 months, COVID-19 has infected and killed 70 and 55 times more people respectively than the previous global pandemic, the 2009 Swine Flu outbreak. The Swine Flu was unique as it was one of the first times the world had the opportunity to leverage its technological capabilities to create an effective vaccine. Before the advent of vaccine production, there was very little that could be done to stop the propagation of the mass illness and death that accompany these viruses. In the early 20th century, the Spanish Flu ravaged a world still reeling from the effects of the deadliest war seen up until that point. While similar in scale, the difference between COVID-19 and the Spanish Flu is the rapid progress of medical science and technology over the last century. We now possess a unique opportunity to innovate our way out of this crisis. 

Recent revelations surrounding the possibility of reinfection go against the traditional notion of herd immunity, which ended the Spanish Flu after nearly 4 years. If we are to create a vaccine for a virus that may never go away, it is necessary that we manufacture and distribute at least 10-20 billion doses at a minimum. This figure assumes that 25% of these will be destroyed due to errors in the storage and shipping process. And we are years from understanding if the COVID-19 vaccine will only need to be administered once. We must urgently re-imagine the international shipping and cold chain infrastructure.

As of 2018, there were 616 Million Cubic Meters of cold storage in the entire world. This is dangerously inadequate if you consider that less than half of the food produced worldwide is refrigerated. The location of cold storage itself is skewed, with countries such as the United States having an almost equal amount of storage space as India, despite having roughly 25% of the population. 

The world is currently capable of producing and distributing 6.4 Billion doses of the flu vaccine annually. A COVID vaccine could require an increase in manufacturing capability by at least 200%. The current estimated storage temperature for the COVID vaccine is –112 degrees Fahrenheit. In contrast, the average temperature to store and ship a flu vaccine is roughly 40 degrees Fahrenheit. 

Transportation also will also prove to be a bottleneck in reaching global immunization. Free trade has brought economic opportunity around the world, but it has also galvanized a complex logistics network. Even the most basic of shipped goods are processed through multiple modes of transportation. The complexity increases when these items are temperature sensitive. Constant temperature monitoring during the shipping process will be a necessity. While temperature monitoring devices exist, many of them have technical limitations that render them unreliable in certain scenarios. For example, continuous access to WiFi or wired electricity can be difficult to come by in the middle of the Pacific Ocean. 

UPS is constructing what they are referring to as a “freezer farms”. Close to their air hubs in both the US and Europe, these facilities are designed to store nearly 3 million vaccines per location. Currently, only 2 are being constructed, but the innovation potential is massive and could prove to be the way forward. 

Another innovation with massive potential is the creation of a “warm vaccine” that can be stored at a temperature of up to 98 degrees Fahrenheit, without the need for cold chain monitoring. The early stages of this innovation are currently being worked out at the Indian Institute of Science.  

The issue of temperature monitoring is also slowly being worked out, with companies such as Parsyl partnering up with vaccine distributors such as Gavi to create individual seals per vile. This monitoring has generated an enormous amount of data, leading to the breakthrough that 5% of vaccine storage refrigeration devices are causing most of the damage to vaccines. The goal now is to fix broken refrigeration equipment before it leads to waste. This is a much more inexpensive and feasible task than having to replace equipment worldwide.   

Epidemiologists estimate that 70% of the population will need to contract COVID before the onset of herd immunity. While nobody truly knows how many people have been infected with COVID, we’re still far away from the nearly 5 billion infections necessary for this. The cost in lives lost will be staggering in order to reach this benchmark, with the brunt of deaths occurring among impoverished people worldwide. The question is, can we produce a safe vaccine and scale up our distribution capabilities in time to prevent this? We have the technology to do so, but mustering the cooperation internationally between business and government may prove more complicated than the logistics themselves.

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